INTERVIEW Standards of Practice: 1. Responsibility and Accountability: Practice safely, being accountable to our patients, providing empathy and being compassionate. 2. Knowledge based Practice: Demonstrate competence by staying up to date with current knowledge and BPG and understanding ours and our team’s scope of practice. 3. Advocacy: Speaking on behalf of our clients when they can otherwise not do so their self. Building therapeutic relationships, using client centered approach as well as family centered approach. 4. Professional Leadership: Relationships with the healthcare team members and demonstrate leadership. 5. Individual Self regulation: We are accountable to regulate ourselves. Code of Ethics: 1. Provide safe compassionate, competent care: Building trusting therapeutic relationships. Nurses intervene when they see care that is unsafe with hers or other nurses’ patients. Admitting mistakes and taking necessary actions to prevent or minimize patient harm. 2. Promoting health and wellbeing: Collaborate with healthcare team to maximize the benefits to the patient and advocating for my patients needs. 3. Promoting informed decision making: Respecting a clients wishes. Ensuring the client has given informed consent. Understanding the power imbalances between the nurse and the patient. When family doesn’t agree with patient decision, trying to educate the family as to why they should provide support. 4. Preserving dignity: when providing care, cover up a part of a patient that is exposed that is not necessary to be exposed. Speak up when it is witnessed that a patient is not being treated respectfully. Don’t condone that behavior. Maintaining appropriate professional boundaries. 5. Maintaining privacy and confidentiality: Promoting privacy by drawing the curtains when doing patient assessments. When disclosing info, only disclosing info necessary. Being respectful when discussing a patient’s clinical situation. Not working with a patient you know personally. Not abusing our access to information. 6. Promoting justice: Do not discriminate based on race or ethnicity or beliefs. Refrain from judgment or labeling. Nurses make fair decisions based on resources available and the needs of their patients. Fair treatment and fair distribution of resources. 7. Being accountable: Nursing is a self regulated practice by keeping up with the standards of practice, laws and regulations. Practicing within the limits of our scope. Seeking knowledge and support when care goes beyond our scope. When care goes beyond our own values and beliefs it is our responsibility to still provide compassionate competent care or switch assignments with another team member if you feel like the relationship between you and your client will be compromised. Be aware of your own biases (they are inevitable) Mission Statement: To be a world-leading haven for people-centered health, healing and learning. Provide advanced level care and training to educate and teach the future generations of health-care professionals. Vision: Healthy people; healthy communities- by helping indivuals improve their health, you will be helping the community as a whole. Mistake/Near Miss: At St. Marthas hospital we use the electronic documentation. This type of documentation ensures that we do our documentation thoroughly without missing critical information to our client’s condition. This is so helpful because it cues us when certain aspects of care are due to be documented on. Ie. Feeding assessment after a meal. The system was down for a couple days because they were enhancing the computer charting system so everyone had to resort to paper charting. When you get so used to charting one specific way, it can sometimes be difficult to adapt. Documentation is so important, it keeps the team informed of the client’s condition and it is support for you if there was ever legal action related to your client case. In my case, I almost forgot to document my patients wound assessment/skin integrity because those cues are not there. However, I felt fortunate to have had lots of experience with the computer charting because I was able to list off in my head the different section I would usually document on the computer and I realized that I had missed a section. I will now use that method anytime I go to document on paper vs. the computer. It will ensure I do not miss vital information to my patient’s clinical situation. Scenarios A patient is unresponsive, what do you do? Airways, breathing, circulation. If airway is obstructed or patent. Take action to open airway, repositioning of head and neck or by extracting foreign body. Assess respiratory effort, labored. This is the most important thing to establish because if the patient is not breathing there isn’t much more you can do. Next check for pulses. Check pulse, HR and whether its strong , reg or irregular. Does pt have hx of blood circulation problems. BP? May have to provide first aid or CPR, the crash cart may be involved. After establishing these 3 things I would need more information of the clients condition, determine why the client is unresponsive. Since the patient is fully dependent on our recovery, after that point I wouldn’t know how to further provide patient care so I would seek assistance and consult a colleague for more knowledge as to what interventions need to be performed next. You, a student nurse, and LPN, and these 3 patients: DELEGATION, younger patient, longer life. What separates you from other students? My interest in a holistic approach to care. Focusing on healing through the mind body and spirit, knowing that most medications (Although some are long term) are not a cure, they are a temporary fix or stabilizer. So knowing that a lot of the health issues go beyond the observational data. My mother is a naturopath. I believe that sometimes a patient’s condition can be improved through assessment of mental attitudes ex. Stress and anxiety relief that can help improve a patient’s condition. Focusing on the underlying issues will help eliminate the stressors and giving someone coping strategies. This can help prevent reoccurrence. I am open to a client wanting other non-traditional interventions. I think this is a great outlook to have because it has made me so open to each clients’ personal traditions values and beliefs because I am so intrigued to learn. And if the intervention increases a client’s wellbeing and comfort, then why would we not try it? Patient safety: Assistive devices, call bells, bed rails, hearing aids, glasses, communication (language barriers), bathroom assistance etc. Palliative Care: Comfort, pain, religious support, family comfort, explanation of process, private rooms Leader: Being a leader does not reflect your job title. Every person who chooses to learn and teach has the ability to demonstrate good leadership qualities. And I believe that as RNs we should all be striving for leadership qualities. Because it is those leadership qualities that make us great nurses. I think it should be an expectation of every nurse to be a leader. It is within our role to teach and educate our clients, it is also within our role to teach and educate other nurses, as well as be taught and be willing to learn from others more experienced. Nursing is lifelong learning. Qualities: Teamwork (Collaborate)- working together improves the health of individuals and community Open and willingness to learn and teach Understands roles and responsibilities Help others achieve their goals Listen and build trusting relationships with clients and team Communication Reflect on the MISSION Slogan: a different today; a better tomorrow- it shows that if we dedicate to providing the highest quality of care and we create change today that by working together we can make a difference by establishing a positive outcome for the future. By living in the here and now and improving today, we have set us up for success tomorrow (future). Ex. we would never send a patient home to fail. We give them all the resources they need to achieve their goals so we can improve their quality of life. What would you do on a night shift? Restocking supplies, ensuring proper documentation, hourly checks on patients Conflict with coworker: Not everyone is going to get along. Some personalities do clash but it’s important that you don’t let that effect the work environment and the teamwork. Instead of focusing on differences, focus on similarities. Try addressing the issues in a respectful manner and hopefully they can be resolved easily and productively. If talking to the person directly does not work, go to management but not before you try other measures because that alone could cause conflict. I am very open and very honest and understanding so I would try to reason with the person first before going to any extraordinary measures. Ex. Going to OR with Liz Ethical Dilemma: First of all I believe that there is never a right solution to an ethical dilemma. But we must come up with a plan of action that provides the least amount of harm. I cannot recall a time I experienced an ethical dilemma, or maybe I have and did not realized what I was being faced with. But I can say that every clinical decision I have ever made, was made with evidence based practice to support it, or the support of a colleague to guide my interventions. Ex. Right to say no. we all know patients have the right to say no, however, what about when it comes to things that a patient needs to survive like food. Patient had a skin graft from the neck for a part of the patients tongue that had been surgically removed due to a tumor. This patient was a male so he was particularly hairy in his chest/neck area. So the graft that was taken had a large amount of hair on it when it was surgically placed on the patients tongue. After surgery the patient was refusing to eat because his tongue was hairy, he couldn’t taste, food was getting caught in the hair. It was an awful situation for that patient to be in. He was very disturbed and unpleased. I don’t know about interventions such as electrolysis to remove hair but something had to be done. I have never experienced a situation like this so I personally don’t know much of what I would have done. What I do know is that I would have provided as much education to my patient as possible and develops coping strategies for this new condition. I’m sure they must have resorted to tube feedings. Why nursing? I love to learn and I love to help others. I personally am very passionate about health and fitness so promoting health is something I love to do. I want to better people’s quality of life. I like to inspire people and everyday in clinical practice I meet a new individual that inspires me. As well as my co-workers. I know that even though I would like to, it would make me a superhero at my job but I don’t know everything, but I have such a willingness to learn, and I am fully aware that I am entering a profession that involves lifelong learning and that’s what I love about it. My boyfriend is a paramedic and has been in the profession for many years. He tells me daily about his experiences and the things he learns and would like to do differently next time and I learn so much from him. He is one of my biggest and biggest supports. He is honestly the person that inspires me the most and makes me aspire to being the best nurse I can possibly be. Flaw: I can be my own worst enemy. For example, this year I have been extremely stressed because I have no financial assistance. I am trying to work and go to school and a lot of students do it but it is not easy. And the demand of nursing school is significantly greater than many other programs. I know for a fact that this has had an impact on my clinical practice. Getting back into clinical I found myself slightly disorganized. However, I acknowledged the issue I was faced with and developed strategies to improve it. First with organization. Once I established that, My practice significantly improved. I can be emotional. However I think this can be both a positive or negative quality. Values of nursing lead you to being a nurse? Professionalism, intelligence (knowledge), Compassion, Learning, Intregity (honesty, truthfulness, displays good character), communication/collaboration, diversity (working in many areas)- thts what I love about the ER ( have to work as a team) My Qualities Empathy, communication, organizational skills, intuition, emotional stability, critical thinking skills, patience, dedication, observant, skillfull, confidence, confidentiality, good personality, repect. Patient centered care: 1. Whole person care- considering the patients traditions beliefs and values 2. Communication- education on dx, care, decision making 3. Patient support and promote patient involvement- help with care so they can go home alone and succeed 4. Access to resources- educating and guiding patient to available supports to achieve outcomes 5. Promoting Autonomy- protecting the rights of the patient (decision making) How long is your preceptor ship? What if I need more time? What would you be looking for in a new grad that is applying for a specialty position like the ER? If you liked my interview and no specialty positions were available from me, would I still be considered for other new grad positions that are available? Would you hire a new grad in a specialty position as casual?